As we age, many of us are faced with the prospect of revising our living arrangements. There comes a time when we become uncomfortable living alone due to the possibilities of falling, health and safety concerns, forgetting to take medications, poor nutrition, etc. If you feel overwhelmed by home upkeep, cut off from transport and social amenities, or simply want more companionship with others your age, an independent living facility or retirement home may be a good option. It is important to recognize these signs early and work with your loved one to determine the most appropriate senior living situation. There is a broad array of senior housing options available to seniors from staying in their own home to specialized facilities that provide around-the-clock nursing care. To begin planning for a new living situation, one must first be aware of the different senior options of elder/senior housing available and to learn which type will best suit your needs.

Below, we have provided information on each senior option of elder/senior housing and care to help you understand which type of care and senior living situation your family should begin to explore.

Independent living communities

Independent Living Communities, also known as Active Lifestyle Communities, Retirement Communities and Senior Living Communities, is ideal for individuals who are active and who can still live independently, but prefer some assistance in home upkeep, chores and provide their residents with convenient access to dining, medical care, entertainment and more. Community layouts vary widely, from apartment-style living to freestanding homes. The independent living lifestyle offers residents a safe living environment, but with minimal assistance. Built to accommodate an active senior lifestyle, many communities will offer a relaxing and socially interactive environment. Often, recreational centers or clubhouses are available on site to give seniors the opportunity to connect with peers and participate in community activities, such as arts and crafts, holiday gatherings or movie nights. Independent living facilities may also offer facilities such as a swimming pool, fitness center, tennis courts, and even a golf course. Other services offered may include onsite spas, beauty and barber shops.

There are many types of independent living communities and they range in costs and the services provided. Below are a few:

Subsidized Senior Housing - In the U.S., there are senior housing complexes, subsidized by the U.S. Department of Housing and Urban Development (HUD), for low-income seniors.

Senior Apartment Complexes or Congregate Care Housing – These types of apartment complexes are restricted by age, usually 55 and older. Rent may include community services such as recreational programs, transportation services, and amenities such as an exercise or media room.

Retirement Communities - Retirement communities can be groups of housing units for those aged 55 or 62 and older. These housing units can be single-family homes, duplexes, mobile homes, townhouses, or condominiums. If you decide to buy a unit, additional monthly fees may cover services such as outside maintenance, recreation centers, or clubhouses. Retirement communities can also be a stand-alone rental apartment community that offers amenities such as meals, laundry, housekeeping, transportation, social events and activities.

Continuing Care Retirement Communities (CCRCs) - CCRCs offer service and housing packages that allow access to independent living, assisted living, and skilled nursing facilities in the same community. If residents begin to need help with activities of daily living, for example, they can transfer from independent living to an assisted living or skilled nursing facility on the same site. Most CCRCs require an entrance or buy in fee, plus a monthly rate that is based on the size of the apartment you choose.

Is an Independent Living Community the right choice for you or a loved one?

Assisted living facilities

Assisted living is a great option for individuals who have difficulty with daily activities needed for living independently. An Assisted Living Community is a long-term residential living option in which residents are free to live an independent lifestyle, but can also receive regular support for a range of daily activities ranging from cleaning to meal preparation. The philosophy of assisted living is to provide personalized, resident centered care in order to meet individual preferences and needs. Housekeeping and maintenance services are often included in the monthly rent, along with laundry services, utilities, assistance getting dressed, transportation and meals. These communities have an overall residential and a more home-like atmosphere and can range from large corporate-managed communities where hundreds of people live in their own apartment, to small private homes. In addition to enjoying the peace of mind that comes from this maintenance-free lifestyle, residents can take advantage of a full calendar of events, activities, out-trips, and countless opportunities for social engagement. Additional care services, such as medication management or assistance taking a shower, are also readily available. Another important aspect of assisted living is that most communities recognize that being able to keep a pet is very important to the resident, and therefore many assisted living communities will allow the senior to bring a pet as long as he or she is able to take care of it.

What is the cost of Assisted Living?
Assisted living costs vary with the residence, apartment size, and types of services needed. The basic rate may cover all services or there may be additional charges for special services. Most assisted living residences charge on a month-to-month lease arrangement, but a few require long-term arrangements.

Amenities in assisted living communities typically include:
• Daily meals
• Transportation
• Housekeeping services
• Personal laundry services
• 24-hour supervision and security
• Exercise and wellness programs
• Social and recreational activities

Personal care in assisted living communities typically include:
• Medication management
• Care for residents with cognitive impairments
• Emergency call systems for each resident's apartment
• Staff available to respond to both scheduled and unscheduled needs
• Assistance with eating, bathing, dressing, toileting, and mobility
• Access to health and medical services, i.e. physical therapy
and hospice services

residential care homes / group homes

Residential Assisted Living Homes, Adult Group Homes, Assisted Living Group Homes, or Senior Care Homes are single family homes, which are typically located in traditional homes and neighborhoods and have been converted into care facilities to offer elder care services for 5-10 residents. These types of senior living accommodation offer a smaller, more home-like family environment for seniors. Due to the high caregiver to resident ratio, residential care homes offer a greater flexibility and are able to adjust quicker to a residents’ changing needs and level of care. Assisted living group homes offer food services, supervised, personal and directed care, activities, health management and provide assistance with daily living, but do not typically have a medical professional on-site. While assisted living communities may offer extensive activities, such as senior aerobics and field trips, a residential assisted living group home is a better fit for someone who needs more individual, home-setting care.

Here are some of the basic services offered in residential care homes/ assisted living group homes:

• Comfortable private, or semi-private, rooms
• 24 hour assistance by on-site certified caregivers
• High resident to caregiver ratio
• Home visits from physicians, podiatrists, beauticians
• Hospice, respite and day care
• Diabetic and oxygen care
• Dietary accommodations
• Dementia and Alzheimer’s care
• Daily home cooked meals
• Laundry and housekeeping services
• Complete medication management & administration
• Toileting, catheter and incontinence care
• Social programs and activities
• Transportation & appointment scheduling

memory care / dementia care centers

Memory Care / Dementia Care units will provide a safe and secure environment for loved ones affected by Alzheimer's or other various forms of dementia that can impair memory and cognitive abilities. Although many are able to care for someone suffering from Alzheimer's or other forms of dementia at home, it may come to a point in the disease process that makes home care unmanageable. While many families prefer to keep their loved one home for as long as possible, a person who suffers from dementia and Alzheimer's will eventually require 24-hour supervised care in catered settings. With the variety of home health services that are available, this may be delayed; but in some instance, placement is warranted for memory care.

Assisted Living Communities with a Memory Care / Dementia Care unit are designed with their residents in mind. Entire wings or even buildings may be designated for individuals suffering from memory impairment and they often provide a different level of supervision and security. For example, Alzheimer’s living environments have secured areas to prevent wandering; a common symptom of the disease. These communities provide intensive, long-term medical care to seniors with serious health and dementia conditions in a fully-staffed and monitored facility. Memory care centers are staffed with caregivers who are trained and accustomed to the impulsivity and reduced safety awareness exhibited by many who suffer from cognitive impairments and require memory care.

Many memory care centers will also offer programs designed to slow progression or alleviate symptoms associated with dementia like agitation and aggression. Sensory stimulation, cognitive therapies, physical and occupational therapies are generally included in these types of memory care programs. There has been a lot of positive research regarding alternative therapies such as music and art therapies, which tend to help reduce anxiety and distress. Most therapies and memory care programs are performed in group settings, which allows for greater supervision of the residents and also provides the socialization that is needed.

Memory care centers/facilities offer 24-hour supervised care with meals, activities and health management for residents. Below are some of the basic services offered in memory care:
• Comfortable private, or semi-private, rooms
• Daily meals
• Housekeeping and laundry service
• Medication management
• Exercise and physical therapy programs
• Social programs and activities
• 24-hour staffing and personal assistance

Skilled Nursing Facilities

A Skilled Nursing Facility is a lot like a nursing home and many times the terms used are one in the same, but a true skilled nursing facility may offer more "skilled" medical expertise and services. A Skilled Nursing Facility provides skilled nursing care and/or rehabilitation services to help injured, sick, or disabled individuals get back on their feet. Skilled nursing facilities usually house more than 100 residents and are staffed by nurses who provide 24-hour care and services.

Whereas, a nursing home, an Intermediate Care Facility or ICF, provides a room, meals, and help for individuals with activities of daily living needs. Residents living in a nursing home usually have physical or memory problems that keep them from living on their own. In terms of rehabilitation in skilled nursing facilities, hospitals make the arrangements for follow-up patient care after an acute hospital stay, like after a surgery. When released from the hospital, a patient transfers to the skilled nursing home to receive hands-on care from nurses. If a patient needs rehabilitation like physical of speech therapy, a patient receives the services until they are able to go home.

Here is a list of the short-term and long-term care offered by skilled nursing facilities:

  • Stroke Recovery - rehabilitation therapy, helping patients regain motor skills and speech functions.
  • Parkinson's Care - specific care required to attend advanced Parkinson's cases (does not apply for all facilities).
  • Custodial Care - helps patients with needs like bathing, dressing and eating.
  • General Wound Care - cleans wounds and administers antibiotics for infection.
  • Acute Medical Conditions - services offered to help cases where an illness, infection or injury threatens the patient's health
  • Terminal Illness Care - services offered along with hospice care for people living with terminal illness and require custodial care and medical care.
  • General Rehabilitation - speech, physical, and occupational therapy and other services to help patients recover after an extended illness or invasive operation.

Families and patients choose skilled nursing facilities when a loved one requires:

  • Medications
  • Incontinence
  • Personal hygiene
  • Assistance with meals
  • Getting in and out of bed
  • Around-the-clock nursing care
  • Close supervision, if someone wanders off

Skilled nursing facilities offer:

  • Blood transfusions
  • Diabetic management
  • Medicare-certified beds
  • Individualized care plans
  • Long-term custodial care
  • Ambulance transportation
  • Therapeutic and special diets
  • Restorative Rehabilitation services
  • Post-hospital and post-surgical care
  • Speech-language pathology services
  • Assistance with activities of daily living
  • Incontinence, catheter & colostomy care
  • Medication administration and IV services
  • Medical supplies and durable medical equipment during the stay

*Limited services may be provided by community staff in independent living. In most cases services are provided by a 3rd party agency.

Consumer confusion about kinds of care can cause trouble on multiple fronts. The lack of clarity about senior community types not only inconveniences families who waste time and energy researching inappropriate care options. It can also potentially endanger the senior when the family’s confusion about the right care type causes a delay putting in place the appropriate kind of care. Or in the rare but troubling cases when communities don’t have top-notch admission procedures, residents may be admitted to facilities that don’t offer an adequate level of care, which is obviously dangerous to the resident. Other times residents may admitted to communities that offer much more care than is required, which usually results in unnecessary money being spent and also a resident who is unsatisfied and out of place because the resident is among the only relatively healthy seniors among a group of elderly people who need much more intense care.

It’s essential that the senior’s chosen community offers enough care, and it’s ideal that residents have the opportunity to be among peers with similar ability levels. These simple, but important criteria can be met when the right kind of facility is chosen. As a free service to the public, we at Arizona Senior Options provide expert senior care referrals and information to help families with the stressful, often emotional process of finding living options. Having a professional to help guide you through the process can make all the difference when it comes to saving time and gaining insight into valuable resources.

Our senior living advisors know which questions to ask on your behalf … and have the experience to suggest personalized and qualified facilities as options for your loved one. If you are in the process of finding living options for your loved one and want to make that determination right now, we encourage you to contact us for free guidance from one of our experienced senior living advisors.