Senior Housing Definitions

Adult Day Care

Adult day care is intended to benefit adults who need a variety of health, social and related support services during the weekday but who have the required levels of support at night and on weekends. This type of care is most often available in a center where able bodied seniors are supervised during the day because other family members are unavailable. Adult day care facilities offer meals and activities. Services have expanded to include physical and speech therapies, baths and salon services, transitional and rehabilitative care.  Others may provide care for memory loss, diabetes, Parkinson's and others.  Search our site for Adult Day Care  facilities by location

Assisted Living/Adult Foster Care/Adult Family Care/Congregate Care/Residential Care Homes

These terms refer to residential facilities that house individuals who require assistance with some “Life Activity” such as self-care (bathing, dressing, etc.), manual tasks (cooking, shopping, driving), walking, seeing and hearing, speaking, memory loss, or have specific health issues such as dementia, diabetes or Parkinson’s.  They may provide only the most minimal assistance with transportation and meals or they may be designed for and staffed with specialists in caring for residents with Alzheimer’s, ALG or Traumatic Brain Injury.

 

Specific therapies, security systems, wider doors, hallways, ramps and roll-in showers enhance the quality of the life and foster the joy of independence for the residents.  Many are four-to- ten bedroom communities that offer a family-like setting, healthy meals, exercise, social activities, physical and mental health oversight, medication monitoring with 24 hour live-in staff.  

 

Facilities are designed and staffed to a specific level of care.  Typically residents live independently with the access to a menu of assistance.  However, some communities accommodate residents with increasing health needs.  Some units may be redesigned for memory care residents, provide for rehabilitative or transitional care after a traumatic health episode or  provide for hospice or paliative care as residents near end-of life. The senior housing/care industry has worked diligently to provide for the needs of their customers.  The lines between types of products have blurred as community poulations shift, market demands dictate and owners strive to maximize the time and talents of staff.

 Just as facility size ranges from small to several hundred units, prices are dependent on staffing levels, size and quality of the community and services required.  Many states require licensure and inspections depending on the level of care.  These facilities are often a wonderful care option for aging adults.  We recommend checking public records for inspections reports, at least three visits before placement and interviewing families of current and former residents before placement. 

In some parts of the country you may find Adult Foster Care facilities.  As the term suggests, AFC’s are homes in which individuals or families take an adult into their home for extended care...

Assisted Living Facilities are also one of the care facilities found in CCRC’s (Continuing Care Retirement Communities) or may simply share a campus with an Independent Living Facility or a Skilled Nursing Community. 

 

Moving is always traumatic and becomes more so as we age.  Once it is determined that some assistance in required, plan for current and future needs.  Fortunately, there will continue to be a wide variety of care choices available as we become more innovative in our service delivery. Search our site for Assisted Living/Adult Foster Care/Adult Family Care/Congregate Care/Residential Care Homes by location

Continuing Care Retirement Communities – CCRC’s or Senior Campuses

Continuing care retirement communities, sometimes referred to as life care communities, provide increasing levels of services as residents age and require them. They comprise a variety of residence types, including independent living, assisted living, and nursing home care in a concentrated geographical area. Most often, substantial endowment fees are required for this product type, together with monthly maintenance fees, with the expectation that services will be provided "for life." Residents typically move into such a facility while relatively young, able-bodied and independent; as needs dictate and increasing service levels are required, subsequent moves are made into appropriate units on the same campus.  Increasingly popular is a slightly different community called a Senior Campus.  This may be one facility where two or more levels of care are available or two or more buildings on a contiguous parcel that provide a continuum of care, from independent living through assisted living and perhaps even long-term skilled nursing care.

 

This type of campus allows for fairly simple progressive moves to housing with additional services as needs dictate; costs increase with the intensity of care and services that are required.  The senior campus option is most often a rental community with rates that vary by the level of care provided. 

Either of these are particularly good options for couples, one of whom requires more care than the other.  Devoted husbands and wives have historically cared for a spouse as they age but eventually the level of care may be beyond the physical or emotional capacity of the caregiver. 

 

In a CCRC or Senior Campus, the necessary assistance can be provided allowing for the couple to remain together in the same or adjoining facility, reducing the burden, the stress, guilt and worry that are often experienced by the care giving spouse and their family members.  Search our site for Continuing Care Retirement Communities or Senior Campuses by location

Condominium, Townhome or Cooperative Ownership

Condominium ownership is similar to single-family homeownership. The owner holds title to the living unit and has joint ownership with other owners in the common areas (e.g., the parking garage and lots, halls, fitness facility, community rooms) as well as the land upon which the building sits. Townhomes are similar to condominiums in ownership structure except that the owner also holds title to the land. The term "townhome" usually refers to a multi-story structure with at least one common wall. However, the term is loosely used in real estate and can refer to a single-level dwelling.

 

For both of these housing types mortgages may be secured and real estate taxes are assessed. Whenever common areas require maintenance, there is a monthly assessment or dues collected by the governing association to cover the costs. This association will generally be governed by written documents administered by an elected board of directors.

 

·     • Ask about pet restrictions, subletting policies, noise restrictions, restrictions on improvements, and insure that you receive a copy of the documents for your review. Depending on the quality and type of the common areas, assessments may be substantial and should be considered in any purchase decision. Assessments may add dramatically to the monthly cost of housing. Depending on the age of the building you should ask for an assessment history, what plans may exist for major projects (e.g., roof or driveway work) and how much money the association has in its reserve fund.

• Although this may resemble single-family, condominium or townhome ownership, cooperatives represent a very different type of ownership. Co-op residents purchase shares in the corporation that owns and operates the property. Most often, the resident is required to sign an occupancy agreement and pay a one-time membership fee in order to move in. This agreement also commits residents to pay their portion of the mortgage and maintenance costs. 

·      • Ask what the share price is. Ask the amount of the underlying mortgage and how much the monthly carrying charges will be. It is important to have a clear understanding of what happens if and when the unit is sold. Some cooperatives permit a “limited equity” that produces only minimal profit at the time of sale. Because the unit is not owned outright, shareholders are only selling their membership and equity at the time of sale. Ask for a list of sale restrictions and insure that you receive a set of documents for your review. Most people have previously lived in single-family homes and apply that experience to any residential purchase. It is critical that you read the fine print and understand your ownership position before buying a share in a co-op. Although cooperatives have become a more common form of ownership, their financing is only done by a select group of lenders. Ask where you can obtain financing before purchasing shares in a cooperative. Search listings for Condominium, Townhome or Cooperative Ownership by location

 

Hospice Care/Palliative Care

Hospice care is provided to the terminally ill. Comforting measures and counseling provides social, spiritual and physical support to patients and their families during this particularly difficult time. Hospice care requires a decision by the patient or other authorized decision-maker in order to discontinue so-called "curative" medical treatments and replace them with "palliative," comfort-providing care. Hospice care may be provided in a person’s own home, or in an assisted living or nursing home environment

 

Palliative care is the medical specialty focused on relief of the pain, stress and other debilitating symptoms of serious illness.  Palliative care is not dependent on prognosis and can be delivered at the same time as treatment that is meant to cure. The goal is to relieve suffering and provide the best possible quality of life for patients and their families. Search for listings for Hospice and Palliative Care by location

 

Independent Living in Market-Rate Housing

This is age-restricted apartment living that may (or may not) offer seniors-oriented services. Rent is not subsidized; residents must be 55 or 62 years of age, depending on whether the property allow families (age 55) or is age-restricted (age 62). Prospects for this type of housing must be able to live independently, require little or no help with household activities, and be able to pay the rent that the owner has established for the living unit, which is leased for a particular term, typically one year (although shorter periods may be available as well).

 

The rental rate, which is specified in the lease, remains constant throughout the lease term, unless the lease provides for periodic escalations. Because these apartment projects are rented either primarily or exclusively by seniors, some services--housekeeping, transportation, meals--may be available, usually at an increased cost. This type of housing is an especially good choice for younger seniors who wish to downsize their living spaces and avoid the expense and bother of maintenance and upkeep.

There are also senior independent living apartment buildings that provide government subsidized rents to qualified individuals.  This type of housing is the same as that described above, except that rent is reduced because of a government subsidy. Federal, state, and local programs provide funds to persons with lower incomes, frequently subsidizing monthly rents by as much as 70 percent. Search our website for listings of Independent Living Apartment Communities by location

In Home Care

This is residential living with certain services contracted by or on behalf of the single-family homeowner. The services may range from cleaning and home maintenance to personal care, including dressing, grooming, meal preparation, bathing, and the like. This type of care may involve nursing or therapeutic care, often to provide help with medications or treatment.

 

In-home health care provides services for short or extended periods of time, and is intended to promote, maintain or restore the health of older adults in their home. It is available throughout the country and is allowing seniors to maintain their independence, remain in their home far longer than might otherwise be possible while paying very reasonable costs for only the care they need for the time it is required.  Services range from companionship to hospice/palliative visits.  Charges are hourly but there is usually a minimum (perhaps three hours).  As levels of care and required skills are required the price increases. 

The availability of this type of care is the cornerstone of our healthcare system. Working families or those that live some distance from an aging loved one can find substitute care and peace of mind at a minimal cost.  This frequently delays or eliminates the need for any kind of institutionalization.  Search our website for In Home Care Providers by location

 

Memory Care/Specialty Care

This type of care is provided in a variety of communities.  Adult Day Care will provide a place for someone to spend the day while family members are at work.  Any of the Assisted Living , et al. communities described above may or may not accept memory care patients or those with specific needs.  Some, however, accept only those that suffer from a specific ailment. 

 

For example, the Lakeview Ranch communities in Darwin and Dassel, Minnesota, specialize in patients with dementia exhibiting aggressive behavior and most of their patients have been evicted from other facilities for this very reason.  I will tell you from experience it is one of the most joyous places I have ever visited.  Skilled Nursing Facilities (Nursing Homes) may also specialize. 

 

 It is well worth the time and effort to seek out a “perfect” community when the need arises to move.  Moving is traumatic and multiple moves can be disastrous for both the individual and their families.  When the community is designed to accommodate patients with special needs and the staff is trained to understand and strives to improve the condition of their patients those in their care tend to thrive rather than waste away.  Search for Memory Care/Specialty Care facilities by location 

Skilled Nursing Homes

Skilled nursing home care, also known as a “skilled nursing facility” or “rest home,” is a type of care for people who require constant nursing care and have significant limitations in daily living. Residents can stay in a skilled nursing facility to receive physical, occupational and other rehabilitative therapies following an accident or illness.

 

These facilities provide 24-hour medical care, including short-term rehabilitation (physical therapy) as well as long-term care for people with chronic ailments or disabilities who require daily nursing care, in addition to help with personal care such as bathing or dressing or simply getting around.  Only a few decades ago a frail elder had only three choices; live at home, live with relatives or go to “a home.”  The third alternative was considered a death sentence by most and is still a dreaded alternative by many.  But the advent of a plethora of new options has given hope to many and caused an industry-wide movement to improve the décor, care and reputation of nursing homes.  Search our site for Skilled Nursing Home listings by location

Rehabilitation, Transitional or Respite Care

People often suffer injuries, accidents, heart attacks, strokes and similar health problems which require some sort of rehabilitation.  They may need to regain an ability such as speech or the use of one or more limbs or simply regain strength.  Hospitals will keep a patient only so long and insurance is very specific about what is covered and for how long.  However, extended coverage is usually provided for this type of treatment.  It can be given at home by a therapist or in a skilled facility with staff that will work with the patient to improve their condition to the point that they are able to return to their previous living arrangement. 

 

Respite care provides a caregiver a break from daily routine and stress. Again, it can be provided in the client's home or in a variety of out-of-home settings, usually ranging from a week to a month in length. Respite care is an essential part of the overall support that families may need to keep a loved one with a disability or chronic illness at home.  Search our site for Rehabilitation, Transitional or Respite Care by location by location