Senior citizens are living longer. They have access to medical treatments which can prolong their lives. Many “baby boomers” encounter difficult decisions about caregiving and living arrangements for their parents. While boomers are concerned about their parents’ well-being, they are often clueless about what housing options are available.
Evaluating the Level of Care Your Parents’ Needs
Safety Issues – Are your parents safe in their home? Is their driving safe for themselves and others? Are they able to take care of themselves?
Medical Issues – Are your parents able to administer and track their own medicine? What medical conditions do your parents have? Are they showing signs of memory problems?
Social Issues – Are your parents lonely? Do your parents have friends they like to socialize with?
Location – Are your parents happy where they live now? How will changing their current living situation affect them?
Cost – Are your parents financially able to sustain a decent standard of living? Are they able to afford their current housing arrangement?
Many parents are making cross-country migrations, leaving home to live with their children. The Chicago Tribune tells the story of Elizabeth Larson.
Elizabeth Larson, 93, moved from Champaign [Illinois] to be near her son, who lives in Hinsdale [Illinois].
My son said that if anything happened, if I needed him, he was too far away,” she said. She thought he was right. And she knew the solution, and that it would involve her leaving Champaign. Larson was sorry to leave neighbors she liked. But she didn’t have to leave her two closest friends. They had already moved to out-of-state retirement complexes near their own adult children. “So it was easier for me to move,” she said. And “in a way, it was kind of exciting. I thought it would be nice to be near my son. ¹
While it was a nice amicable move for Elizabeth, it can be a gut-wrenching decision for others searching for senior housing options. Moving is a complex and confusing decision. The earlier you assess your parents’ desires and needs the better it will be. By becoming aware of the different housing options available, you may be the biggest asset helping your parents come to terms with their living arrangement. Communicate with them, give them time to consider the options and be kind and gentle as they face one of the most difficult decisions of their lives.
Most Common Housing Options for the Elderly
Independent Care—Consists of single family homes or townhomes for self-sufficient seniors. They offer security and social activities in their community living setting. Services such as laundry, meals, transportation and social activities are usually provided. They are not regulated by the government. Independent Care facilities have a country club environment. The average cost to rent or buy a home, including community fees, can be up to $2,000 per month or more. They are also called retirement communities, retirement homes, or senior apartments.
Assisted Living—A community which provides 24-hour assistance. The personnel assists with eating, bathing and bathroom use. However, 24-hour medical service is not provided. Their care usually includes laundry, meals, transportation, social activities, toilet care, housekeeping and medication aid. Assisted living communities are regulated by the state. Other names for assisted living facilities are personal care homes, eldercare facilities, residential care facilities, group homes, and community residences. The cost ranges from approximately $2,300-$5,500 per month.
Nursing Home—A community which provides 24-hour assistance with daily living and medical care by nurses and therapists. Nursing homes include doctors on call, hospice and end-of-life services, medication aid, housekeeping, toilet care, bathing, dressing, transportation, and laundry. Nursing homes adhere to both state and federal regulations. They are also called rest homes, convalescent homes, and skilled nursing facilities. The cost averages between $4,000-$12,000 per month.
Continuing Care Retirement Communities (CCRC)—Campus-like communities which provide care from private residences to assisted living and skilled nursing care. They are designed for individuals with declining conditions. Many times the residents move from one community to another as their conditions change. The services are the same as nursing homes. CCRCs have some state regulations. These facilities are also called Continuing Care-Retirement facilities and life care facilities. Services and costs vary depending on what level facility one is in.
Aging in Place—Many seniors decide to age in place. This is a living arrangement where the elderly and their children have made the choice to live in the children’s home, their parents’ home or the home of their choice for as long as they are capable. When assistance is needed, nurses, private aides, physical therapists and other needed personnel will come to the home. Many seniors need to remodel their houses to make them suitable to meet their needs as they age. Financial planning is a must to handle living and home and providing for any outside help. ²
Defining Types of Care for the Elderly
Skilled Care—a type of intermediate care where the patient or resident needs more assistance than usual, generally from licensed nursing personnel and certified nursing assistants. This care is not the same as long-term care, in which a resident may not need the services of a licensed nurse on a daily basis.
Custodial Care—care when seniors need caregivers to help take care of them. Unfortunately, many older adults reach a time in their life when they can no longer care for themselves. They cannot get around the house without assistance. They cannot do the things they once did, as their physical and mental skills are not quite as sharp as they used to be. A caregiver may make all the difference between an older adult struggling with life’s demands and an adult who has a helping hand.
Palliative Care/Hospice Care—a special type of care offered to patients who are at the end of their lives. Both hospice and palliative care centers are about providing the best care possible to their patients.
Hospice care most often occurs in a home environment. Hospice is not a place—It is a concept. A hospice team consists of doctors, nurses, social workers, spiritual personnel, therapists, aides, and volunteers. Hospice does not focus on treating medical problems; rather, it centers on keeping the elderly pain-free, comfortable and happy during their last days. In the Hospice Handbook, Larry Beresford says, “While hospice is care for the dying, it places special emphasis on life and living each day as fully as possible.” ⁴ Eligibility in most hospice programs require an estimated death within the next six months due to the terminality of the patient’s illness.
Palliative care centers around the concept of care also. A nurse is there to lend support to the patient and family and to manage the pain and other symptoms which are affecting the patient. Palliative care usually occurs in a facility such as a hospital, assisted care facility, or nursing home that is associated with a palliative care team.
Due to different policies, It is important to consult with your physicians about what type of care is best for your parents.
Home Care—a type of medical and assisted living in which the care provider works with the patient within their own home. Typically, the process involves an initial meeting between the care provider and patient to determine the personal needs and the level of care required. The care provider and patient will then come up with a personal and customized program to make sure the patient’s needs are being met. The health care provider may be either a licensed professional or a part of a company which specializes in assisted living. Typically, assisted living organizations are comprised of nurses, doctors, and other medical professionals and are assigned to each patient based on their own specific needs.
Residential Care Homes—In some areas, residential care homes are the last resort in terms of finding placement for residents who don’t quite meet the criteria for nursing home care, but may not have the funds for assisted living. Residential care homes also tend to be a good choice for seniors who have mild mental health issues that hinder their ability to live independently or to be accepted into assisted living facilities.
Adult Day Care—places senior citizens into the hands of licensed professionals who are fully capable of taking care of them. For many people, this is a way for the elderly to get out of the house and socialize with other people. Socialization is extremely important; some people could easily slip into depression if they don’t have someone they can talk to.
Companion Care—Companions for the elderly. Companion care personnel are usually trained by their company in safety and CPR. They are also called comfort caregivers. No certification is required to be a companion. ³
Honor your father and your mother, that your days may be prolonged in the land which the Lord your God gives you. (Exodus 20:12)
How to Pay
Often finding housing for our parents boils down to financial ability to pay for services. Without going in depth, some ways to finance parental care are to use private savings from the parents or children, money from the sale of a home, long-term insurance, reverse mortgages, Medicare or Medicaid, VA benefits, stocks/bonds, or any other financial means family or parents possess.
As children face the prospect of caring for their aging parents, complex decisions about housing are imperative. Each housing options listed above comes with benefits and complexities. It is up to the family to educate themselves on what is available by communicating with them and providing time to formulate a plan that works for all parties involved.
When my father passed away, my husband and I decided to move into my mother’s home to care for her. It was a mutual decision on our parts with the understanding that we would talk if the situation was not working well for any of us. As retired baby boomers, our situation allowed this arrangement. While it isn’t for everybody, it was a mutual decision made in the best interest of both my mother and ourselves.
As you face any upcoming living arrangements for your parents, be open-minded, respectful, realistic and informed.
The expression “there’s no place like home” is true. But, when the time comes when parents need to consider whether to move or not, let’s make sure that whatever plan is crafted creates a secure, comfortable and pleasing environment for all involved.
Whoever speaks, is to do so as one who is speaking the utterances of God; whoever serves is to do so as one who is serving by the strength which God supplies; so that in all things God may be glorified through Jesus Christ, to whom belongs the glory and dominion forever and ever. Amen. (1 Peter 4:11)
Cease striving and know that I am God. (Psalm 46:10a)
Therefore, having been justified by faith, we have peace with God through our Lord Jesus Christ. (Romans 5:1)
Dear Lord, As I face caring for my parents, please help me honor and respect them in all decisions that must be made regarding living arrangements. I trust that You will guide me and give me wisdom as plans and decisions are made. Thank you, Lord, for helping me. In Jesus’ Name. Amen.
Member Inspirational Writers Alive; Bible Gateway Blogger Grid Member
Coming Soon: Caregiving Part 5: Spirituality
Edited by E. Johnson; Bible verses are taken from the NASB if not noted otherwise.
¹ Older Parents Divulge What It’s Like to Leave Home to Live Near Adult Kids. Chicago Tribune. 5 June 2015. http://www.chicagotribune.com.
² Paying for Senior Care. https://www.payingforseniorcare.com. 5 May 2017.
³ Assisted Living Today. http://assistedlivingtoday.com. Accessed 5 May 2017.
⁴ McGovern, Sue. What Everyone Should Know About Hospice. St. Meinrad: Abbey Press. 2004. Print.
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Books by Patti Greene