When Home Isn't the Best Place to Live

Making the Tough Decisions

Probably the hardest decision a caregiver has to make is placing a loved one in a nursing home or assisted living facility. However, it isn't one you have to make alone. It's important to weigh the input of the patient's doctor, therapist and other family members.

Some local and state agencies provide free evaluation and case management services for those over 65.

Understanding Housing Options

Most seniors want to stay in their own homes and, as long as their health allows and they feel safe in their community, it is probably the best option.

However, declining health, accidents and illnesses may require assistance of some kind. There are a number of available options that may be considered.

In-home services - For seniors who need help with personal care, household and lawn chores, cooking, driving, shopping, etc. in-home care may extend their ability to remain in their own homes.

Assisted Living Facilities - Residents are provided meals, housekeeping, activities, transportation, and security. Most importantly, they receive assistance in managing their medications and, if needed, help with personal care such as bathing and dressing. Costs are usually based on the level of assistance required and may rise as a resident’s care requirements increase.

These facilities encourage a "home-like" atmosphere where residents use their own furniture and some even allow residents to redecorate and remodel their apartments.

Nursing Homes - Provide care for patients requiring comprehensive care and/or multiple types of services such as rehabilitation therapy after surgery, a stroke, or heart attack. Some provide long-term care for specific diseases such as Alzheimer's or Parkinson's Disease.

Independent Living Retirement Communities - These retirement communities are open to those who don't want the burden of home-ownership, the work of meals and housekeeping, or who may need to leave an unsafe neighborhood, yet are able to live independently. Seniors can rent an apartment in a cottage, duplex or high-rise building. These communities provide dining options, game rooms, gym or spa facilities, transportation and activities. Seniors can enjoy the surroundings, services, and the company of their peers. Residents may buy their residences or lease them. In addition to entry fees, these communities usually charge a monthly service fee.

Continuing Care Retirement Communities - These facilities combine the availability of independent living, assisted living and nursing home care in one setting. Services are available, as needed, and residents can move from one to the other without leaving the "neighborhood." These conveniences usually require a sizable entry fee and high monthly service fees, but offer the reassurance of eventual health coverage up to the nursing home level.

Most new CCRCs are available on a rental basis, rather than earlier "life-care endowment" purchases. Reimbursement of entry fees to residents who leave to their heirs in the case of death, vary between communities and should be carefully considered when making the decision.

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