Independent Living - Other Options

At some point there may be a time when alternate housing for Mom/Dad will become a consideration for the folks. This may be a planned move to a retirement home or community. It may be that they have just "outgrown" their home or they want to move to another area - for any number of reasons.

It is possible that the folks have planned for a long time to retire to a quiet, remote place of tranquility - the cabin in the mountains or a cabana on a secluded beach. This is a wonderful goal and one they've worked hard for. One consideration of this idyllic notion, given the state of their health/medical needs, is the proximity of services should they be needed.

Trying to decide on where the folks should live for maximum safety, comfort and independence may be one of toughest and most emotionally fraught decisions your family will have to make. Moving from one home to another at any age can be an emotional decision that can be complicated by financial and physical logistics.

There is sometimes a misconception that once an elderly person enters a hospital that the "next stop" is a nursing home. In fact only a small percentage of seniors reside in nursing homes, roughly 20% for those over 85 and only about 6% for those 65-84.

Home health care, at any age, has many advantages. It is more personal and familiar. There is a more privacy and better access for friends and family for visitation. Home health care is less expensive than nursing homes.

Here are other considerations for independent living.

In An Adult Child's, Friend's or Relative's Home:
Having Mom/Dad live with you is something only you can imagine - they're your parents. Family dynamics of relationship and responsibility (including financial) will dictate the outcome of this decision. Having an adult parent(s) living with you may offer a full and rewarding experience. In times past this was not uncommon and is still the norm in many countries including the U.S. But again the key is the relationships amongst family members and how those dynamics work/fit together.

From a practical standpoint the "new" home should be assessed for the accommodations it can offer the folks. As noted above in the "At Home" section thought and planning should include safety, accessibility and the community services available to them. These are important considerations because they can be as critical to you as they are to your parent.

An unsafe obstacle or hazard may result in a fragile hip break. Your nice big home in the country can deprive a senior of community contacts and services necessitating more immediate family involvement.

In the discussion and planning some thought must be given to what can best be described as the 'rules and regulations" of the household. Although not in the strictest sense are these rules so much as they are "understandings" - or acknowledgements of who is responsible for what? Who pays for what? Who's responsible for what? Having a discussion about these understandings or guidelines before Mom/Dad move in can preempt future turmoil and "mis-understandings".

.A final word. This section discusses the parent(s) moving into a relative's house as an independent living situation, which it may well be. Consider though that over time this senior will likely become more dependent. What started as an "independent" older adult living in can become a person requiring consistently more and more care. This might progressively continue on through Hospice care.

Accessory Apartments ("Mother-In-Law"Apartment, "Granny Flat"):
Also termed by officials as an Accessory Unit this description typically refers to a separate living unit attached or adjacent to the main house. It can be an upstairs apartment, converted garage or a cottage behind the main house. The distinguishing characteristics are that this living area has its own kitchen and bathroom accommodations and often a separate entrance.

This type of living arrangement will offer a greater degree of privacy than if Mom/Dad were living in your home while the close proximity provides many personal and social advantages.

ECHO Housing - Elder Cottage Housing Opportunity:
Another type of Accessory Unit the ECHO is specially designed modular housing for that meets the needs of elders. These units are moved onto a property usually on the side or back yards of existing homes.

The units are designed to meet the needs of seniors. They are energy efficient and barrier free. They can be design/built to match existing architectural structures and they can be easily moved when no longer needed. Like the accessory apartment they provide independence and privacy while having the folks close to the family.

Accessory Unit Considerations:

• Physical Space - Is there room in the yard for an ECHO unit? Does your house lend itself to creating a separate apartment for Mom/Dad?
  
  
• Economics - When compared to other long-term housing options an Accessory Unit might can make good economic sense. An ECHO unit can cost approximately $25-30,000. Preparing an apartment in your home will depend on what you have existing and what you need/want to provide.
  
  
• Zoning Laws - Nearly every community has them regarding housing. Check with the local housing/permitting departments in your area. Also check with the Local Area Agency on Aging. They can provide some knowledgeable insights and experience.
  
  
• Neighborhood - Is your particular neighborhood conducive to this plan. The NIMBYs (Not in My Backyard) might object to the changes an Accessory Unit may cause the neighborhood.
  
  
• Property Title - Are there deed restrictions or covenants that could prohibit a planned unit?
  
  
• Property Tax - What impact will an accessory unit have on your property taxes?
  
  
• Accessory Units such as an apartment or ECHO house can be an ideal housing solution for Mom/Dad provided that all considerations have carefully weighed. Preparation of the unit can be done by you or a local contractor.

Plan on some time spent to get the appropriate permits and selecting contractor. Refer to recommendations noted above in home modification. For assistance contact the local Area on Aging or Better Business Bureau.

Additional helpful information on Accessory Units can be found at the Administration on Aging (AoA) - ELDERCARE LOCATOR 1 800 677-1116 - www.aoa.gov/housing/modification.html. AARP has some booklets on the subject of ECHO Housing (D12212) and Accessory Apartments (D1187), at 1800 424-3410 - www.aarp.org

Senior Communities - Apartments, Condos, Mobile Home Parks:
There are many types of Senior Communities and they offer a wide range of services and amenities. Generally speaking the Senior Community or Congregate Housing as it is sometimes called, is suited to the active individual or couple who are able to live on their own.

A Senior Community may be a very good housing option for the folks for any number of reasons. Usually these communities offer a variety of appealing social, recreational and cultural activities. Services such as meals, transportation, housekeeping, security and medication dispensation may be offered.

A Senior Community can be Retirement Hotel, Apartment, Condo or Mobile Home Park. They will require that Mom/Dad be mobile and pretty much able to take care of themselves.

The financial obligations will vary as to the types of services offered. Sometimes a monthly fee will cover everything or there may be extra charges for meals, housekeeping, etc. The quality of the facility and services will vary widely as well. It is most likely the folks have done a thorough amount of research and referencing.

A consideration to keep in mind is that a prolonged illness or inability to care for one self may require moving from some Senior Communities as they are not hospitals and generally do not offer acute onsite medical treatment.

Homesharing
Sometimes referred to as Shared Housing, Matched Housing or Group Shared Housing this living arrangement is often appealing to older persons particularly women. Matched Housing is the pairing-up of two individuals. Group Shared being three or more unrelated individuals. Common areas such as the living room and kitchen are shared. The bedrooms are typically individual private areas with bath accommodations determined by specifics of the home.

Although not for every one, home sharing can be a good arrangement with the right circumstances and individuals (think back to college roommate days with the benefit of maturity and wisdom).

The benefits to be considered are chiefly economic and social although in some cases it may be to get some help around the house. If a parent is considering this idea it would be good to weigh the pros and cons. In what ways would this arrangement benefit Mom/Dad and what are the downsides?

Home sharing can have its personal considerations as well. A person has to evaluate the consequences of a non-family member living with them. Certain inner feelings and thoughts will be examined. "How well do I really know this person?". "How well do I want to know him/her?", "Do I trust this person?", will be thought about but perhaps not openly discussed with anyone.

Everyone and their situation - financial, home, interests - are unique so there are no set "rules" when assessing this housing option. It is best to look for a compatible person and for starters agree to set up a trial period to see how things work out. There are other considerations that should be taken into account.

• Zoning - It would be wise to check local ordinances for zoning restrictions preventing unrelated persons sharing a home. The same may apply to apartment building regulations.
• Taxes and Insurance - Determine whether home sharing will affect property taxes and home insurance.
• Social Security - If your parent(s) share a home in exchange for income this will affect their income and adversely impact Social Security Benefits. Contact the local SSI office for advice (Blue Pages in local telephone directory).
• Food Stamps - If your parent(s) receive Food Stamps their eligibility is determined by total "household" income. Contact the local Social Services office (Blue Pages) or the local Area Agency on Aging.
• Agreements - Your parent(s) may enter into an shared housing agreement either as a tenant or landlord. Some local jurisdictions do not accept these types of agreements as legal contracts. Contact your local Area Agency on Aging for advice and suggestions. Find them in (Blue Pages) or through the ELDERCARE LOCATOR - 1 800 677-1116. See www.aoa.gov/housing/SharedHousing.html

The American Association of Retired Persons (AARP) also has good consumer information on Shared Housing. 1800 424-3410 www.aarp.org/getans/consumer/homeshare.html

Be certain to check with the local church or synagogue, libraries and senior centers as they have information on senior/elder housing.

Government Assisted Housing
Government housing assistance is comprised of different programs made available to low-income families, disabled and elderly persons. As these programs are difficult to get into due to long waiting lists and strict financial guidelines they should be considered only if necessary.

Of the government assisted housing programs including Section 8 and Public Housing, the program most suitable for seniors is Section 202 Housing. This program is specifically set up for seniors and offers the best array of services and possibilities.

There are strict income guidelines and many areas have waiting lists. However Section 202 Housing programs do offer some advantages such as transportation and meal service. This can offer the opportunity to live in a better environment with other seniors and have lower housing costs.

If you are interested in low to moderate housing for seniors contact the American Association of Homes and Services for the Aging (AAHSA), a national non-profit organization that can provide information on assisted living, nursing homes, continuing care, retirement communities and senior living at 1 800 508-9442 or at www.aahsa.org.

Also be sure to check with the local housing authority (Blue Pages of phone directory) or Area Agency on Aging - ELDERCARE LOCATOR 1 800 677-1116 or refer to www.aoa.gov/housing/gahousing.html.

Group Homes
This is a category of housing that includes Board and Care Homes, Group Homes and Foster Care. It usually consists of five to twenty residents who share a home like environment. The residents should be mobile and fairly self-sufficient.

Depending on the specific nature of a particular facility the Group Home resident may or may not be responsible for certain household chores such as cooking and cleaning. Some will have full or part-time housekeepers and managers. Some Group Homes will have a set all-inclusive monthly fee while others can charge a fee and charge for extra expenses.

A Group Home may be a good housing option for Mom/Dad given that it meets criteria suitable to them. The idea of moving into such a place may not seem all that appealing to your parent given that they may be leaving their home and living with strangers. This can be difficult and challenging for some people.

The quality of facilities will vary greatly due to its staff, residents, location and other intangible elements recognized by Mom/Dad. A good facility will offer a home-like environment and residents can often form good friendships.

If a Group Home housing arrangement is to be considered it is best to visit some and be prepared to let the folks spend some time visiting with the staff and residents. What are the important things to consider in a Group Home?

• Private or semi-private room?
• Bathroom facilities - shared or private?
• The fee. What does it include? All meals or just some? Housekeeping? Including laundry service?
• What other services are available and associated costs?
• How many people live there?
• What interests do other residents have/share?
• What kinds of activities are available on-site - nearby?
• What say do the residents have regarding activities?
• Can Mom/Dad bring/use their own furniture and accessories?
• What kinds of transportation services available?
• Location. Is the home readily accessible to family and friends?
• Are there community based services available? If so what are they and how provides them?
• How close is Dad/Mom's doctor, hospital/HMO?

A Group Home housing arrangement may not be suitable for Mom/Dad for any number of reasons. But it may be the best of the alternatives considered. Many people find this to be a good home usually because of the amenities and friends with whom they may share some common interests.

Remember if a time comes when Mom/Dad become unable to care for themselves they will be required to move to an assisted living program. An assessment of the folks overall well being should be considered in light of this

Continuing-Care Retirement Communities (CCRC's) - a.k.a. Life Care Communities
Moving into a Continuing Care Retirement Community is a choice the folks will likely make themselves. This is because the choice is made at a time of Independent living when it is their choice. This form of retirement living is described in this section on Independent Living because this is generally considered to be a long term housing arrangement that commences when one really is independent. In fact one has to be in good health before entering.

This relatively new form of retirement living has some distinct advantages that the folks may find appealing. Probably the unique quality that sets CCRC apart from nursing homes and assisted care facilities is that they are long-term homes that provide all or most all services that a senior may need. Besides the housing other services are included. Nursing is provided on the premises and in most cases a clinic or hospital is as well.

The CCRC option can be expensive but costs should be weighed with the services provided and balanced with anticipated long-term needs. Over a period of time if one parent needs medical care the other can remain in the home.

The folks will likely remain in the CCRC for the remainder of their lives. Depending on the facility they may own or rent their apartment or condo. Their housekeeping, social, cultural and recreational activities are available a set monthly fee or as used basis depending on the facility and their contract.

If the folks are considering a CCRC it is suggested to visit a number of them. They will want to evaluate the services and features offered at each and inquire about the contracts available. These are legal contracts that should be examined carefully and with consideration towards their specific needs and desires. CCRC contracts will vary is costs and scope of services. It would not be a bad idea to have the family attorney review a contract before signing.

1.Housing Intro
2.Independent Living - At Home
3.Independent Living - Other Options
4.Semi-Independent Living
5.Dependent Care