What are the main types of senior housing and residential care?
Senior housing is a group-living situation where senior citizens can live in proximity to their peers and partake of a wide range of activities and special services. Senior housing ranges from single-family homes in a senior community to large group living facilities.
People who explore senior housing as an alternative for themselves or a loved one find a complex and often confusing array of options and descriptions but senior housing really consists of just 3 basic types:
Nursing home care
Assisted living is sometimes called “board & care” and “congregate housing.” Residential care that combines all 3 housing types is called Continuing Care Retirement Communities (CCRC’s). This gives us 6 major senior housing options:
Independent Living – For healthy seniors who are self-sufficient and want the freedom and privacy of their own separate, easy-to-maintain apartment or house, along with the security, comfort and social activities of a senior community.
Assisted Living – Numerous kinds of housing-with-services for people who do not have severe medical problems but who need help with personal care such as bathing, dressing, grooming or meal preparation.
Board and Care – State-licensed assisted living for people who need minimal assistance with personal care such as bathing, dressing, grooming or toileting, but who need or want communal meals and easy access to social contact with peers.
Nursing Homes (Skilled Nursing Facilities) – Facilities with 24-hour medical care available, including short-term rehabilitation (physical therapy) as well as long-term care for people with chronic ailments or disabilities that require daily attention of RN’s in addition to help with personal care such as bathing or dressing or getting around.
Congregate Housing – Used to be considered a unique combination of private living quarters combined with shared activities including communal meals and other social activities, but is now considered a type of assisted living.
Continuing-Care Retirement Communities (CCRCs) – A complex of residences that include independent living, assisted living and nursing home care, so seniors can stay in the same general location as their housing needs change over time, beginning when they are still healthy and active.
How do I determine what type of senior housing arrangement is best?
After familiarizing yourself with the types of residential care, it’s time to conduct a thorough inventory of the senior’s wants, needs and goals. Some key issues to consider:
Temporary versus long term care: An older person may go to a nursing home for rehab following a surgery or stroke, then return home. In other circumstances, a senior’s needs are better served by planning a move into a situation that is likely to remain the same for the many years to come.
Independence: Can the senior live alone, and more importantly, does he/she want to? Or would living in a more service-oriented environment be more nurturing?
Privacy: Independence and assistance generally form a continuum: privacy decreases as the need for assistance increases. If the senior's desire for privacy is paramount, independent living, assisted living, or a Continuing Care Retirement Community would all be preferable to a board & care home or a nursing home.
Needs for personal care: How much and what kinds of personal or “custodial care” are needed or desired? There are online needs assessment questionnaires to help determine this and then match the care needs with the right type of housing.
Needs for medical care: If the senior has a chronic illness that necessitates special medical care, or ongoing services of medical professionals, independent living and even assisted living may not be suitable.
Costs: Learn about the financial aspects of senior housing to determine what options are affordable for you.
Walk through and evaluate several care facilities or senior communities that seem suitable. Reviewing facility comparison checklists can help you determine which type of environment fits the senior resident’s requirements and preferences.
Seek guidance from professionals who are experts in senior housing issues such as medical social workers, case managers or geriatric care managers. They can help with all phases of this process: identifying goals and values, assessing needs, determining what is affordable, and suggesting appropriate facilities.