Post #33 Where do I begin? Part 3

A comprehensive guide to senior living for Baby Boomers

Happy Fourth of July weekend, everyone!

July 4^th symbolizes freedom in America, and I’ll use that as a jumping off point to talk about our freedom to live out our senior years as we wish to.

You have options.

In Post’s 28 and 31, I started a discussion called, “Where do I begin?” as people have been calling and writing me once they are close to making a decision that a change has to be made in their living situation – due to aging and/or changing of circumstances – they really don’t know where to start .

I suggested two pre-decision thought patterns. In post 28, I urged you all to try and “cop” the mindset (sixties saying) of “living with assistance,” - that being no matter where you lived you were still trying to live the life you want, but different, maybe

slower, maybe less, but you were still going to “live” and get the assistance you need as additional added support. This is opposite the traditional emphasis in many assisted living communities where your “care” comes first and the “living” is secondary.

In Post 31, I also urged you, before you start searching for senior communities, to do some soul-searching, and put some real thought into how and where you want to live this next stage of your life. It is different for everyone, whether you are an extrovert, introvert, have passion about some element in your life, if you are in a relationship or if you want to begin new relationships. It is like having your own, personal, senior mission statement.

Now that we’ve gotten those things out of the way, I’m going to lay out for you all of your options for you. I’ve counted 14 of them! There may be more! No wonder it is hard to get started! You probably know of two or three options, but not all fourteen!

So here we go - consider this your “guide to getting going” in senior living.

First, I want to say, I don’t want to overwhelm you! Quite the opposite. I’ll be going over each option slowly. In this post, I’m going to just write a few lines or a paragraph about each one. Then in subsequent posts, we will go over them more in detail.

This can be exciting!

The main point I would like to make is – this can be exciting! Besides the current models out there, we will explore new, cutting-edge models most people have never even thought about. The point is to get your mind going, so you can be creative in your decision making.

For those who think 14 may be too many options, you’ll be happy to know I have divided them into two main groups. They are:

1. Staying at home with different forms of homecare and

2. Moving to the different types of senior communities

I hope you will use keep this guide and use it in the future, when you need it.

So, grab a cup of coffee. Here are your fourteen options:

Staying at Home

1. Staying in your own home with some personal care coming in daily.

This is traditional home care, usually 3-4 hours per day, $25-30 per hour. You are living how you want to live, but food choices, activity choices and socialization are limited.

2. Staying in your home with an adult child or children living with you

This is the way things used to be before senior living even existed. Now, it is good for those with lower incomes. And you get to stay home.

3. Living in your adult child’s home

Again, the way it used to be. Here you get to hang out with your grandkids. Good for finances. Not great for activities and socializing with others your age.

4. Having a caregiver live with you

People who needed round-the-clock care or supervision used to do this before the assisted living revolution, and some still do. With immigrations issues these days, however, it may be harder to find someone. It’s good on the pocketbook, as you are subsidizing part of your care costs by giving someone room and board. You also get some socialization as someone is always there with you. But there is not much activity or socialization with people your own age.

5. Cutting edge – having another person who needs assistance live with you in your home.

It’s the VRBOization of senior care. All single-family homes can now be a senior living community. This will be an interesting choice for Boomers. By having another person live with you, it could save you money so you don’t have to give up your home or the equity in it if you don’t want to. And you have someone to talk with. There are a lot of pros and cons in this model.

6. Cutting edge – you living with someone else in their home.

Same as #5 above, except you are living in their home. Good for those who don’t want to move into a senior living community. Again, good on the pocketbook. But you are living in someone else’s home. It has its pros and cons.

7. Cutting edge – Moving in with a group of your friends.

This is a most exciting option to me. You and a few friends can all live together in one of your homes. Or you can pool your resources and create your own little senior community, with all the amenities you want. Need a library – no problem. Pickleball court – can do it. Want a big garden, it can be done. And you can share the expenses of a caregiver. I believe many Boomers will be doing this or something like it. Why not live with people you love?

Living in a Senior Community (the different options)

8. Moving to an “active adult” community

This is the new buzz word – “active adult.” It is what it says it is. It is for high physical functioning seventy-year-olds who want to be active. Lots of golf, tennis, pickleball, great food and socialization, while living in a high-rise or condo. It is what a retirement home used to be, but on steroids. No personal care here unless you bring it in.

9. Moving to an Independent living community.

This is a senior community without personal care, but you can usually purchase it “a la carte”. No more lawncare, snow removal, 2-3 meals a day with some level of activities and socialization. It may have a little bit of an “ick” factor, as you are living with a bunch of older people in many times older community. People are less active then in Active Adult. It’s the old model of independent living and may not be that appealing to some Boomers.

10. Moving to a medium/large assisted living community (AL)

This was the revolution of 1990, when a residential, social model of care was invented for those frail individuals who needed 24-hour supervision, but didn’t need high-level nursing home care. It has evolved into the modern-day nursing home, with higher acuity, but in a residential setting. It is great for those who need a good amount of personal care. Unfortunately, most AL’s focus on the care first, and your quality of life second, which I always had a problem with. The good ones address this issue. It can be a beautiful, hotel-like setting in which to live out your later years even when needing a good deal of personal care. It can be pricy, starting at about $4000 and going up to $9,000, depending on location, level of care, and level of amenities. Not much government subsidies.

11. Moving to a small, assisted living community – (sometimes referred to as a group home) (also AL)

These are small, usually 6-person group homes in a single-family home. It is an older model which was the assisted living before there was assisted living. It has its pros and cons. It is more intimate, has a homelike environment, and is usually less expensive than your typical AL. But they don’t have professionals in each field, so the food is usually not as good, there are fewer activities, and fewer options for socialization than in the larger AL communities.

12. Moving into a memory care community (MC)

This is for people who cannot stay home any longer because of dementia and need 24-hour supervision. They may or may not need physical help. MC’s are usually in assisted living communities in a separate wing. The atmosphere is usually much nicer than in a nursing home, but it can be very expensive and for the most part, not government subsidized like nursing homes.

13. Moving to a nursing home (NH)

These days nursing homes have two primary functions – one, for those who need a lot of personal, medical or dementia care, AND have no funds except your social security. This is one of your perks as a US citizen. If you have the money, then you would usually move to an assisted living community. Second, this is where Rehab takes place, paid for by Medicare. Nursing homes have nurses 24/7 and can handle complex medical conditions, while most AL’s just have nursing assistants with one nurse supervisor and are there for personal care, not medical care. The quality of care in a NH can be all over the board, as there are very high staff ratio’s in government funded Medicaid nursing homes (up to 15 residents per one resident assistant). Quality of life is usually poor, as these are institutionally-built buildings with two in a room, built 25-50 years ago. This is why they built assisted living communities.

14. Moving into a Life Plan Community (CCRC)

Life Plan communities used to be called CCRC’s. They are very large senior communities, sometimes with over 1000 people. They have ALL the levels of care - independent Living, assisted living, memory care, and nursing home care, with most people in independent living, and with smaller AL’s, MC’s and the nursing home. They usually charge a large up-front fee in the hundreds of thousands of dollars, which you mostly will get back when you leave (die). There is still a hefty monthly maintenance fee, only somewhat less than if you were in a stand-alone assisted living. You get priority to move into the assisted living and nursing home, which is one the primary benefits, and can give you peace of mind, knowing you will not have to move off the campus even if you decline. Being so large, the activities and socialization are usually outstanding. It’s your own little city (of old people). Some love it, some don’t.

Short-term rehab

I don’t count short-term rehab as an option, as, by definition, it is short term! Short-term rehab is Rehab. When you break your hip, or knee, or have a procedure of some kind and need “Rehab,” that’s where you go. Medicare pays for up to 100 days, but 100% for only 20 days. The usual length of stay is now 13 days, as a result of all the Medicare Advantage plans which try to keep costs down. Most people don’t know this, but “Rehab” usually takes place in a nursing home wing. This isn’t always pleasant, as some nursing homes are 50 years old. There are some newer ones which were built specifically for Rehab. Try to get in those if you can!

In the next post, Part 5 of getting starting, I will talk in more detail about all the Staying Home options. In part 6 of this series I will discuss the Moving to a Senior Living Community options in more detail. Together, posts 28, 31, 33 and 34, 35 and 36 will make up the whole series, for those of you who may want to print them out and put them together.

I know this was a lot! But I wanted you to have one place where you could get a quick overview of all your choices. Keep reading and you’ll be a senior living expert in no time!

For any of you who want help navigating through this ocean of senior living, feel free to write or call. Creative Senior Solutions, (see below) our company, helps people and organizations navigate through these muddy waters.

I hope you are enjoying the summer. All the best,

Dean

Dean Solden is the founder and owner of Creative Senior Solutions (CSS), a management, development and consulting company specializing in senior living. (www.creativeseniorsolutions.com).

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You can reach Dean at (734) 260-3600 or dean@creativeseniorsolutions.com.

If you like music, check out Dean’s music at deansoldenmusic.com for some jazz, blues, and funky piano/vocal tunes.