“If you don’t have a plan, someone else will make one for you”
The conversation between you and your spouse, your parents or other loved ones about their living situation is best had before a crisis hits. Too often, decisions are made under pressure, resulting in an unexpected and hurried move that may not be the right fit. Knowing the options for senior living and care in advance and, more importantly, what your loved one’s preferences are, bring the best outcomes.
Senior Living Options
The options for senior living have changed greatly in the past 30+ years, and almost entirely for the better. As may be expected, the greater the amount of care and attention that are required, the higher the costs of the services.
In-Home Care – Many people prefer to stay in their home for as long as possible. Assistance with activities of daily living (ADLs) may be provided by family members or contracted caregivers. The advantages of staying at home are obvious; the disadvantages are the disruption of family members’ lives who provide care and/or the costs of outside providers who charge by the hour. Other options such as adult day care are also available to ease the burden on family caregivers, but those come at a cost as well.
Independent Living – This lowest level of care, almost like living in a regular apartment, often includes services and amenities specific to the needs of engaged, older adults. The communities may include various formats, but there is plenty of common space. Call buttons or general oversight is included with awake staff. Only private pay is accepted.
Assisted Living – This higher level of care, more expensive than Independent Living, is a supported living environment for those who need assistance with ADLs as well as social and community engagement. Laundry, meals, snacks, activities, cleaning, utilities, fall-detection, 24-hour assistance, and transportation (usually) are all included.
Memory Care – These services are similar to Assisted Living, but are designed for residents with memory impairment that makes it unsafe for them to stay at home. Memory Care requires a diagnosis of dementia for admission. Communities do not offer heavy, intensive medical care, but do provide a secured environment with higher staffing levels to ensure safety and encourage residents to be actively engaged in activities.
Skilled Nursing Facilities – Skilled Nursing Facilities may also offer transitional care or rehab services with around-the-clock nursing care and supervision. This represents the highest level of care, and it comes with the highest costs.
What Are the Factors to Consider?
Five factors determine appropriate senior housing, three of which are under your control: ability to pay, location, and type of community in which you want to live. You don’t have control over what your needs are or what options will be available at the time you need care, though there are steps you can take to have a say in this, to a degree.
Your Ability To Pay – If you can pay out of pocket, you will have more options. Payingforseniorcare.com/maryland reports that the average hourly rate for non-medical home care in Maryland in 2019 was $21.49. According to Genworth, the median monthly cost of Assisted Living in the Baltimore area in 2019 was $4,300. As the population ages, that cost is expected to rise. Depending on your circumstances, there may be options available to help you pay for senior living.
Location, Location, Location – In making your decision, you will want to consider such questions as: Do you want to stay where you have lived most of your life, move closer to your children, or go somewhere new? Do you like all four seasons?
Type of Community – Your answers to the above and the following questions will help determine your right fit. Do you prefer a small or large community? Do you thrive on social interaction with many or are you content seeing the same faces every day? How important is access to your religious affiliation? What activities and amenities are you seeking?
What Will Your Needs Be? – Your specific health care needs can drive what communities are available to you. Understanding which communities can do what can help make your decision-making process less frustrating.
What Will Be Available When I Need It? – Timing can be everything. Independent Living communities may have waiting lists that are years long. Assisted Living and Memory Care may not have vacancies when you suddenly need them. What can be done? Getting on the wait list of your preferred independent community may allow you to downsize at your pace with the knowledge you are going to end up where you want to be. For Assisted Living, there are short-term options (“respite care”) that can ensure you are receiving the care you need until there is room for you at your preferred option.
What Is the Next Step?
First, and foremost, start having the conversations about senior living if you haven’t already. You will make a better decision by laying the foundation while you are not under pressure. Second, when you do face this difficult decision, know that you are not alone; there are resources available to help you navigate.
Special Thanks to:
Perry Welling, Certified Senior Advisor®
Owner – Assisted Living Locators