Ron SmithPublished on Jun 1, 2023

Senior Housing and Care Choices - More Than You May Think!

When it comes to decisions regarding housing at the time of retirement, most everyone is simply trying to decide where they want to live. Will they stay put or move to a new location? What kind of opportunities and amenities are they seeking? Maybe they are considering downsizing their home, but initially most everyone is focused on a new, exciting lifestyle to tackle their dreams.

Independent Living Housing Choices:

Our primary decision is usually where do we want to live? What do we want to do there? Who do we want around us? Some may be making age-related decisions, such as, moving to a single-story home to avoid climbing stairs, but few are considering aging in place. After all, we’re healthy and searching for the “active adult” lifestyle! Our primary choices generally are:

• Remaining in your current home – a no brainer. You love your house, your neighbors and your community. Your friends and relatives are nearby. No need to change doctors, auto mechanics or where you shop. Besides, you’ll need that extra space when our kids and grandchildren come to visit.
• A new home in another community of choice – This is generally a matter of chasing lifestyle – more sun, water sports, year-round golf or tennis, no snow blower! Your comfortable buying a house anywhere that appeals to you.
• Active adult/55+ retirement communities – you’ve decided you want to live in a resort style community largely with other senior adults. Residents typically live in single-family homes, condos or townhouses that they have purchased. Tend to be homogeneous communities. You’ve selected your new bathing suit, polished up your golf clubs and asked what is pickleball?You’re ready to go!
• Senior apartments – are becoming the rage. Flexibility is the key! All of the benefits and amenities of the more traditional retirement communities, except that you are leasing your apartment and you are free to do something else after your lease runs out. A great way to test the lifestyle, the location and still have the freedom to go elsewhere if you choose to. Space constraints will probably require you to downsize your possessions, but that’s not necessarily bad!
• RV living – for some, this is the chance to explore! RV life gives you the freedom to explore all those places that you’ve heard about and possibly identify where you would like to settle down after the adventure wears off. For most, this is a 1–2-year activity but it can last as long as you want it to.

Housing Options with Assistance:

Health problems, the availability of caregiver resources, financial security, loneliness, the lack of safe accessible housing and the lack of family support often force retirees to reconsider where and how they will live during various stages their retirement years. Accidents or sudden declines in a retiree’s health can dramatically change their housing needs. The following list highlights many of the housing or care options that are now available:

1. Living at home with additional homecare support - provided by agencies, friends or family. This is where a home that has been properly prepared for aging in place really pays off. Most people according to AARP studies want to stay in their own home as long as they can. COVID-19 drove home the value of living in your own home. Care can range from cleaning assistance, companionship, support with the activities of daily living (ADL) and all the way to skilled nursing.
2. Assisted living – is residential living that can occur in a small group home or a large commercial facility. It helps those in need of minor or limited assistance with ADLs and 24-hour monitoring. It provides an opportunity for socialization, meals, laundry, activities and coordination for medical services needed on a periodic basis.
3. Nursing homes – similar to assisted living, but now medical support plays a larger role. More nursing, rehab training, more frequent access to doctors and an RN always on duty. They furnish a much higher-level of medical support and custodial care services.
4. Memory care facilities – are specialized services and facilities to care for loved ones with dementia or related illnesses. This type of residence needs to protect residents from wandering away and care workers need the special skills required to deal with this horribly progressive disease.
5. Skilled nursing facilities – are an in-patient rehabilitation and medical treatment center staffed with trained medical professionals. They can provide the medically necessary services of licensed nurses, physical and occupational therapists, speech pathologists, and audiologists.
6. Combinations of the above: Multiple levels of care in one community. Can be expensive but eliminates the need for residents to move to different communities as medical assistance and care requirements increase.
   1. Continuing-care retirement communities (CCRC) - offer two or more of the above care options within one facility and program.
   2. University-based retirement communities (UBRC) – are university based like the new Mirabella Retirement Community offered at ASU. This is a true continuing care retirement community integrated with lifelong learning through ASU.
   3. Life Plan Communities – the new name for continuing care retirement communities (CCRC). They offer an all-inclusive, maintenance-free and low-stress lifestyle that ensures maximum independence and a full social calendar. They provide peace of mind, security and predictability for your future by offering residential living, assisted living, skilled nursing and short-term rehabilitation services and memory care – all on one campus. Life plan communities help provide a secure and predictable solution to live out your life with confidence.

Other Senior Living Choices:

A plethora of other creative options exist where seniors share space and responsibilities with other people. These solutions have been responses to the needs for lower cost housing options, shared responsibilities/caregiving and social isolation. They include the following options:

1. Living with your kids in their houses – moving in with your children can be a good solution under the right circumstances. Usually most successful when the family is able to maintain some boundaries with mutual respect.
2. Accessory Dwelling Units (ADUs) – sometimes known as “granny pods” are separate self-contained, smaller housing units located on the grounds of a single-family home. You have private space but are still near your family. The main impediment to an ADU is zoning laws.
3. Co-housing – co-housing uses a shared decision-making model, and residents are expected to participate in chores and meal preparation. Co-housing is a shared option that is often intergenerational including seniors and children resulting in more diversity and energy in the community.
4. Home-sharing/roommates – rent out your extra space to a roommate. Usually means shared common spaces. Helps to offset housing costs and reduce isolation. In larger metropolitan areas, there are companies, such as, Silvernest, Nesterly and Senior Homeshares that can help to facilitate these arrangements. Word of mouth suffices in smaller communities.
5. Board and Care – a name often given to a small, assisted living style home. Services may be limited but can include medication management, personal help and transportation. May be licensed in some states.
6. Intergenerational communities – often a popular option in college towns where seniors rent extra pace to students. The advantage is that the senior gets extra income and has someone in the house for conversation and security and sometimes light chores.

In some areas, intentional intergenerational communities have been developed to encourage multigenerational living and socializing throughout the community. Arizona’s City of Surprise is a great example of such an effort.

Longer life expectancies, financial considerations, health challenges and family considerations can greatly alter the directions that we might take in retirement to satisfy our housing and care needs. As we age, we may choose other options. But as you can see from the above examples, market needs are continually driving new and creative solutions.

Ron Smith is a living-in-place advocate, a member of the Age-Friendly Maricopa Advisory Committee, a Certified Aging-in-Place Specialist (CAPS) and a Certified Living in Place Professional (CLIPP™)

This article was published under a different title in the October 2022 issue of InMaricopa Magazine.