Senior living: An overview of traditional housing options

Senior living housing encompasses a number of options, including independent living with in-home care, assisted living, skilled nursing care, and more. Selecting the right community can make a big difference in helping you or a loved one live your healthiest, most rewarding life in your later years.

Senior living

According to the U.S. Census Bureau, nearly 17% of the population is ages 65 and older, growing nearly five times faster than the total population over the last 100 years. As people have aged, the demand for senior living options has risen.

Most older Americans say they want to live in their own homes as long as possible. But that can't always happen due to illness, injury, or other circumstances.

People often consider senior living options if they need help with activities such as meal preparation and dressing, if they are experiencing social isolation, if they have health or memory problems, or if they have lost a partner. It's a good idea to plan for senior living before it may become necessary.

Some seniors today are considering new group housing trends such as home sharing. But most turn to traditional senior living, and there are a variety of choices.

Active adult communities

Active adult communities can be apartments, condominiums, or separate homes. To be considered an adult community, at least 80% of the residences must include one person age 55 or older.

These communities are not much different from living in a traditional neighborhood, but they offer some helpful benefits. Many will take care of outside maintenance, such as lawn care, trash pickup, and snow removal. They also offer activities and social events to help keep people connected, along with facilities such as pickleball and tennis courts, fitness rooms, swimming pools, and clubhouses for large gatherings.

However, active adult communities don't offer services to help with daily personal or health needs. Residents prepare their own meals, do their own laundry and cleaning, and provide their own transportation for shopping and doctor visits.

Independent living with in-home caregivers

Some older people find they can remain in their own home but need help with activities that have become challenging for them or their partner, such as cooking, cleaning, bathing, driving, and even some basic and more advanced medical care.

Services that range from companionship to skilled nursing care are available from professional caregivers that you pay to come to your home on a regular schedule. They can include:

• Personal care assistants (PCAs), who perform basic nonmedical services like cleaning, meal preparation, running errands, and arranging for transportation.
• Home health aides (HHAs), who provide services similar to PCAs but who also have extra training and certification to perform minor medical tasks such as checking blood pressure.
• Certified nursing assistants (CNAs), also called licensed nursing assistants (LNAs), who can assist with daily activities such as dressing, grooming, and bathing; perform tasks like changing bed linens; provide basic medical care; and also monitor and record things like vital signs and  blood sugar levels. CNAs must pass a state licensing exam, and they generally work with a supervising nurse.
• Registered nurses (RNs), who provide advanced health services that include wound care; evaluating symptoms and conditions or response to medication changes; working with physicians to develop treatment plans; and providing emergency care.

As you age, experts advise that you periodically assess your abilities and how well you're managing on your own in order to decide if you need in-home caregivers.

Continuing care retirement communities

Continuing care retirement communities (CCRCs) bridge the gap between independent living and assisted living, with the ability to opt for more care if your needs evolve. They resemble active adult communities in that you live independently in your own apartment or house, and they offer programs and activities.

You generally pay a monthly rent that may include meals, maintenance, and light housekeeping. If you eventually need more services, you can switch to a higher level of care within the same community, such as assisted living, memory care, or skilled nursing. There often is no need to move to a different living space.

Assisted living

Assisted living facilities are for people who need help with activities of daily living but who don't need the 24-hour care that a nursing home provides. You have your own apartment, but the facility provides meals in a dining area, housekeeping, laundry, and help with things like bathing and taking medications.

These communities offer a homelike setting and a measure of independence and privacy, along with the security of knowing that assistance is available if you need it.

Many assisted living facilities also offer social activities, and sometimes care for people with Alzheimer's disease or other forms of dementia. Some assisted living facilities are combined with nursing homes, in case you eventually need a higher level of care.

Skilled nursing and long-term care facilities

Skilled nursing care is provided in nursing homes, also called long-term care facilities. At these facilities, at least one registered nurse is on site 24 hours a day, 7 days a week, to provide skilled nursing services.

These facilities provide comprehensive health and personal care services, focusing more on medical care than on social activities. Services offered may include nursing care, 24-hour supervision, meals, help with bathing and dressing, and rehabilitation services such as physical, occupational, and speech therapy.