Independence & Fulfillment / Housing Article:

Retirement community? Nursing home? Assisted living? Making sense out of living options for seniors

Retirement life can be fun, active and fulfilling - but it can also be challenging when it comes to making choices about where to live.

While many seniors prefer to stay in their own homes, lifestyle preferences and health often prompt a decision to examine other options," says Karen Tynes, chief executive officer of the Washington Association of Housing and Services for the Aging (WAHSA). "For older adults and their children, who may be unfamiliar with the types of residences available, these decisions can appear overwhelming."

The Healthy Aging Partnership - a coalition of 30 nonprofit and public senior and health organizations in the Puget Sound area, including WAHSA - offers these tips to help take some of the worry out of choosing a place to live as we age.

Several different types of senior residences exist, including:

Retirement apartments provide housing for seniors who enjoy relatively healthy and unrestricted lifestyles. Most offer extra services such as housekeeping and meals, while providing organized activities for residents.

Assisted living facilities or boarding homes provide housing, meals and assistance with activities of daily life. Residents live in an independent room or apartment, but have 24-hour nursing supervision for such things as medication, bathing or dressing. Residents also enjoy a variety of social activities.

Nursing homes provide skilled nursing care for elderly people who can no longer live independently because of changes in physical or mental health, emotional trauma or chronic illness. Registered or licensed nurses provide care on the orders of an attending physician.

Continuing Care Retirement Communities (CCRCs) offer residents lifetime care through the availability of independent living, assisted living and skilled nursing care. These communities also provide services such as meals, housekeeping and laundry, along with social and recreational services.

Adult family homes are single-family homes, located in residential neighborhoods, which care for up to six residents. They provide housing, meals and some assistance with daily living activities.

In contemplating a move into one of these types of facilities, consider whether it is conveniently located near friends, family and activities you enjoy. Does the organization have a religious, fraternal or governmental affiliation, and how does that affiliation influence the services and activities offered? Is it for-profit or not-for-profit? Some not-for-profit homes have foundations that will subsidize the cost of care for residents who exhaust their funds.

After establishing a list of residences that meet your basic criteria, plan to personally visit several. While visiting, ask questions to help you determine if it meets your specific needs and standards of quality. What kinds of scheduled activities and programs are available for residents and families? What personal belongings may the residents bring with them? What role do the residents have in establishing the facility's policies? You should also inquire about meals and snacks for residents. If possible, arrange to have a meal at the facility.

Finally, financial considerations are very important. The U.S. Department of Labor has prepared a typical budget for a retired couple, indicating that no more than 60% of their income should be used to support them in a retirement community.

When visiting a prospective home, find out what services are included in its basic charges and whether there is an entry or application fee. Ask to see a list of extra available services and their fees and clarify under what conditions any of the fees might be subject to change.

Several resources exist to assist in paying for long-term care. Medicaid may pay for some care. Medicare may cover care for a set number of days after a hospital stay, but only for certain limited conditions. You should not rely on Medicare as a major payment source. Additional financial assistance may be available through Social Security, Department of Veterans' Affairs, pensions, some insurance policies and the Department of Housing and Urban Development (HUD). All payment sources are subject to change; they should be verified before you begin your search.

For more information on living options as we age - or for free and confidential answers to all your questions about life as an older adult - call the Healthy Aging Partnership's toll-free information and assistance line at 1-844-348-KING (1-844-348-5464) or visit the Web site at www.4elders.org. HAP is generously supported by HAP partner agencies, Puget Sound Energy and the Comprehensive Health Education Foundation.